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Inspection carried out on 05/04/2018

During a routine inspection

This practice is rated as Good overall. The practice was previously inspected on 27 June 2016 and was rated as Good overall.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced comprehensive inspection at Castleford Medical Practice on 5 April 2018 as part of our inspection programme.

At this inspection we found:

  • The practice had systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes. We did however identify that processes in relation to the receipt and actioning of medicines safety alerts did not give assurance that all alerts had been identified or actioned.
  • The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
  • The practice had a systematic approach to service improvement and had introduced new processes and working practices when they identified areas of below average performance or when patient satisfaction was low. For example, they offered open access appointments on a Monday 8am to 10am when patients who called the surgery received an appointment that day.
  • Staff involved and treated patients with compassion, kindness, dignity and respect.
  • Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
  • There was a strong focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider should make improvements are:

  • Review and improve the practice’s processes in relation to the receipt and actioning of medicines safety alerts to ensure that all relevant alerts are received and necessary actions taken.
  • Review and improve portable appliance electrical testing procedures to ensure that all equipment is tested at required intervals.
  • Review and improve the level and detail of information contained in staff personnel files to include information with regard to staff immunity status.
  • Keep under review the ongoing structural issues regarding the fabric of the practice building.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Inspection carried out on 27 June 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Castleford Medical Practice on 27 June 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

  • There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
  • Risks to patients were assessed and well managed.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
  • The practice had developed a whole team approach to clinical areas of work which included long- term conditions. A GP, nurse and health care assistant had been allocated to focus on each long- term condition such as chronic pulmonary obstructive disease (COPD), heart disease, asthma and stroke, and worked closely together to meet the specific needs of these patients. This developed and spread knowledge across all tiers of the practice.
  • The practice offered electronic-consultations with secondary care specialist consultants (an e-consultation is a mechanism that enables primary care providers such as GPs to obtain specialists' inputs into a patient's care treatment without requiring the patient to go to a face-to-face visit by using IT based communication links and data sharing).
  • The practice participated in a number of programmes to improve health and wellbeing locally, these included:

    • Participation in a local Vanguard programme which aimed to improve delivery of health care and care planning for patients in residential and nursing home settings (Vanguard programmes seek to develop new care models which support the improvement and integration of services for patients).
    • Past participation from April 2015 to March 2016 in a project aimed at reducing health inequalities in the Castleford area. It sought to achieve this by the provision of targeted clinical, emotional and care support to hard to reach patients with long term conditions. Actions included longer appointments, proactively following up non-attenders and providing additional home visits.

  • Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day. In addition open access appointments were available on a Monday when patients could call the surgery and receive an appointment that day.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
  • The provider was aware of and complied with the requirements of the duty of candour.

We saw one area of outstanding practice:

The practice operated a “One Stop” service for elderly patients. When an elderly patient has had a consultation appointment but required additional tests such as blood tests these were organised and delivered as part of the same visit. This meant the patient did not need to return to have these carried out.

We saw one area where the provider should make improvement:

The practice should develop and adopt a system to confirm that appropriate action has been taken by staff following patient safety and other alerts.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection carried out on 08 July 2014

During a routine inspection

Castleford Medical Practice is located in The Health Centre, Welbeck Street, Castleford and provides primary care to 5437 patients. The practice is registered with the Care Quality Commission (CQC) to provide the following regulated activities: diagnostic and screening procedures; family planning; maternity and midwifery services; surgical procedures and treatment of disease, disorder or injury.

The practice provides safe, responsive and effective care for all population groups in the area it serves.

We found a proactive approach was taken to involve and seek feedback from patients and staff. The practice is developing systems to monitor and improve the quality of service. Patients we spoke with and those who completed CQC comment cards felt supported and were treated with dignity and respect.

There are effective systems in place to ensure the service is delivered to the widest range of patients with varying levels of need. There is good collaborative working between the practice and other health and social care agencies which help to ensure patients receive good care that meets their needs.

The practice manager joined the team in May 2014 and is in the process of making sure systems, processes, policies and procedures meet current guidance and best practice. As a result procedures were not fully embedded at the time of our inspection. Improvements are needed in documentation and checks relating to medicines management and recruitment procedures.

CQC Insight

These reports bring together existing national data from a range of indicators that allow us to identify and monitor changes in the quality of care outside of our inspections. The data within the reports do not constitute a judgement on performance, but inform our inspection teams. Our judgements on quality and safety continue to come only after inspection and we will not make judgements on data alone. The evidence tables published alongside our inspection reports from April 2018 onwards replace the information contained in these files.